Gabrielle Canon

Editorial Fellow

Gabrielle is a Renaissance scholar and graduate of USC, where she recently received a master's in Specialized Journalism. Her work has also appeared in LA Weekly, the Huffington Post, and the National Catholic Reporter. Connect with her on Twitter @GabrielleCanon or email gcanon[at]motherjones.com

For close to four years, while he underwent chemotherapy, Rhett couldn't be vaccinated against dangerous and contagious diseases like measles and whooping cough. He had to rely on others around him for protection: As long they were vaccinated, transmissions were unlikely. But as a student in Marin County, California, an area where many parents file personal belief exemptions enabling their kids to opt out of required vaccines, Rhett was at risk.

In recent years, the number of parents who use nonmedical vaccine exemptions has been on the rise, contributing to record numbers of vaccine-preventable outbreaks. After the Disneyland measles outbreak, which accounts for most of the 150 new measles cases reported across 17 states since the beginning of the year, Rhett and his family began calling on legislators to put limits on vaccine exemptions—and they weren't alone.

Last Wednesday, in conjunction with advocacy organization MoveOn.org, Rhett helped deliver a petition, along with 21,000 signatures, calling on California legislators to support a new bill that would put an end to nonmedical vaccine exemptions and inform parents about immunization rates in California's schools.

California has been hit the hardest in the recent outbreak, but it's not the only state now seeking to curb vaccine exemptions. Nine other states—including Oregon, a state with one of the highest percentages of parents who file exemptions—have proposed legislation that would eliminate either personal belief exemptions or religious belief exemptions.

Other states have introduced vaccine bills that would make exemptions harder to obtain or increase the ability of health officials to track where vaccination gaps exist. Overall, since the beginning of this year, 79 vaccine bills have been introduced in 29 states.

Not everyone is happy about it. The National Vaccine Information Center (NVIC), which describes itself as the "oldest and largest consumer led organization advocating for the institution of vaccine safety and informed consent protections," and issues online action alerts about legislation that would make it harder to opt out of vaccines—and instructs members on how to fight against it.

Vaccine advocates, however emphasize that the new bills are vital to public health. "This is not a matter of private health, like home birth or vitamin choices a family makes in their own home," MoveOn member Hannah Henry, a mother of four, wrote in a statement included with the California petition. "It is not about politics; it is about children's lives."

In today's terrifying health news, the Los Angeles Timesreports that two medical scopes used at UCLA's Ronald Reagan Medical Center may have been contaminated with the potentially deadly, antibiotic-resistant bacteria carbapenem-resistant Enterobacteriaceae (CRE). Two patients have died from complications that may be connected to the bacteria, and authorities believe that 179 more patients have been exposed.

Most healthy people aren't at risk of catching a CRE infection, but in hospitals this bacteria can be quite dangerous: CRE kills as many as half of all people in whom the infection has spread to the bloodstream. The Centers for Disease Control and Prevention (CDC) are working with the California Department of Public Health to investigate the situation, which is expected to result in more infections.

The problem isn't just in Los Angeles, though. Last month, USA Today reported that hospitals around the country struggle with transmissions of bacteria on these scopes—medical devices commonly used to treat digestive-system problems—and there have been several other under-the-radar outbreaks of CRE.

This is pretty scary stuff, considering that we are starting to fall behind in the antibiotics arms race against bacteria. Due in large part to unnecessary medical prescriptions and overuse of antibiotics in our food supply, these superbugs are on the rise. In a study published last year that focused specifically on hospitals in the Southeast, researchers reported that CRE cases had increased fivefold between 2008 and 2012.

As Mother Jones' Tom Philpott wrote recently, unless something changes, it will only get worse:

in a new report, the UK government has come out with some startling global projections. Currently, the report finds, 700,000 people die annually from pathogens that have developed resistance to antibiotics, a figure the report calls a "low estimate." If present trends continue, antibiotic failure will claim 10 million lives per year by 2050, the report concludes. That's more carnage than what's currently caused by cancer and traffic accidents combined.

The CDC has, in recent years, amped up its efforts to contain the growth of antibiotic-resistant bacteria and has developed a toolkit to help educate both patients and medical practitioners. The Obama administration has increased funding in 2015 for CDC research into how to better detect these types of infections. It also expanded the National Healthcare Safety Network to track threats of superbugs and areas of antibiotic overuse.

Can you imagine a day when antibiotics don't work anymore? It's concerning to think that the antibiotics that we depend upon for everything from skin and ear infections to life-threatening bloodstream infections could no longer work. Unfortunately, the threat of untreatable infections is very real.

I ring the buzzer at a downtown San Francisco rehearsal space and the door swings open. Mike Burkett, sporting a fading pink mohawk, offers a handshake as he shows me up the stairs.

Burkett, 48,is best known as Fat Mike, founder of the San Francisco record label Fat Wreck Chords, and the irreverent frontman of legendary punk band NOFX. With its unique brand of raucous pop-punk and onstage antics, the band has sold millions of records, cultivating generations of fans in the three decades they've been performing.

Now, after five years of writing, finessing, reworking, rehearsing, and self-medicating to complete Home Street Home, his new Broadway-style musical production, Fat Mike is hoping to win over a different audience, and bring them into his world, for a couple of hours at least.

Home Street Home tells the story of a young runaway who joins a "saucy tribe of slutty, castaway street punks," according to the website description. Along with a catalog of infectiously catchy songs, it offers audiences a "celebratory exploration of sex work, drug use, pain, and BDSM power exchange."

But don't expect another cheesy rock opera or genre-bending attempt. In addition to writer/director Soma Snakeoil (a professional Dominant and fetish-movie star who is now Burkett's fiancé), he's brought in Jeff Marx, co-writer of the Tony Award-winning musical "Avenue Q," and veteran Los Angeles stage director Richard Israel. On the day of my visit, with just two weeks left before opening night, the cast and crew were working out the final kinks and last minute changes. It was almost ready.

"We are just about to rehearse the roughest scene," Burkett tells me over his shoulder as we walk into the bustling studio. We sit across from the performers, and he whispers explanations about what we're seeing. The scene is a flashback that reveals why Sue, the lead character, ran away from home. When Burkett starts describing the accompanying song, I tell him I've already listened to the entire soundtrack. "What did you think?" he asks anxiously.

Writers Jeff Marx, Soma Snakeoil, and Fat Mike. Shervin Lainez

In truth, I hadn't just listened to it, I'd devoured it. The soundtrack was released in advance of the show, and featured plenty of punk-world notables. A partial list includes Frank Turner, Alkaline Trio's Matt Skiba, Tony Award winner Lena Hall (Hedwig and the Angry Inch), Dance Hall Crashers’ Karina Denike, and members of Descendents, Lagwagon, the Mad Caddies, and Me First and the Gimme Gimmes. Even the late, great, Tony Sly shows up on one of the tracks.

I already knew most of the words, had picked out my favorite songs, and had been unsuccessfully fighting to get them to stop looping in my head. Even with limited knowledge of the plot, the songs stood on their own, a strange but perfect marriage of the peppy show tunes I grew up on and the punk rock that helped me find myself as a teen.

NOFX, and many of these other bands, played a big part in that, so it was surprising to learn that Fat Mike cared about my opinion. Wasn't he, after all, the fearless role model of the "don't give a fuck" philosophy so many of us tried to embody as insecure teenagers?

"I liked it a lot," I answer simply, before Burkett concedes his anxiety over how the soundtrack would be received. He'd written it, after all, more with Broadway in mind than 924 Gilman Street. Breaking into the theater world was a lifelong dream.

"Rocky Horror changed my life when I was a kid. Growing up, that phrase—'Don't dream it, be it.'—that stuck with me forever."

"The first record I ever heard was Rocky Horror Picture Show," he recalls. "I saw it on TV—too young, like 8 or 9—and I taped it on my tape recorder. Held it up to the TV and taped it. And that is what I listened to for years. That is what I am trying to do. Just how Rocky Horror changed my life when I was a kid. Growing up, that phrase—'Don't dream it, be it.'—that stuck with me forever."

But there's still work to be done and Burektt won't be satisfied with good-enough. He jumps up frequently to weigh in on the details, from costume fittings to vocal range. "We have to train these people to sing punk," he says with a smile. "No vibrato allowed!"

With Home Sweet Home, he's had to pick his battles—frustratingly foreign territory for a guy used to calling the shots. "For a NOFX record, I write usually 15 songs, finish em, no one says shit to me, and I decide which 12 I like best. For this, I had 28, 29 songs, and one by one they just keep getting cut, cut, cut. I write the song and the director goes, 'This doesn't make any sense' and 'You can't write this' and, 'This is not what we are trying to go with here.' Songs I spent months working on!" he says. "So, people are telling me what to do, from fucking every direction!"

Even the way he writes songs needed to be adjusted. "All the songs I wrote for this originally were just songs, and I thought we could build a story around it. But the songs have to be story-driven. The goal in the musical is to have people talking and then suddenly they just go into song. It is not like, 'Hey, here we go!' and 'Watch this one!' and then you start singing a song about elephants or whatever. You have to write lyrics thinking about what's happening."

"The show is about chosen family. How all these kids move to the street because it was better."

He and Soma often acted out the roles as they wrote to make sure the lyrics were realistic and that the song was building the story. It wasn't that much of a stretch, considering that much of the storyline was culled from their own lives. Both spent time on the streets as teens, relishing in the freedom and seeking solace in the company of other street kids—many of whom are reflected in the play's characters.

Some of them turn to prostitution to survive. Others to drugs and alcohol. And the story includes many situations that may be hard for some people to stomach. But Burkett sees it as an honest portrayal of teens living on the street. They don't want your pity, he emphasizes. These kids are not lost souls.

"The show is about chosen family. How all these kids move to the street because it was better. How these kids were all screwed over but they are all happy and they are in a great family," he says. "Looking down your nose at people is ridiculous. And that's what this shows, that these kids are happier than most of the fucking people in the world—even if they are homeless and hookers and drug addicts."

Burkett hopes his new audiences will be open to a culture and experience that might seem to them far removed. "You feel a little bit odd to the world. You feel different. And that's why it all started right? People don't fit in. That is what is punk about it," he says. "These kids are outcasts and had really shitty childhoods and they came together."

Home Street Home opens February 20 at Z Space in San Francisco. For now, there are only 11 performances scheduled. Burkett hopes it will go far beyond that. "I hope it is as successful as Avenue Q or Hedwig. My goal was to write something similar to Rocky Horror—a cult classic musical. And I think we have done that."

If nothing else, Burkett offers audiences a new way to see stories from the streets. "None of this was about anything except writing something that is going to be really remembered," he says. "I think people's attitudes will change from this—maybe they will look at street people and drug users and prostitutes and get a good glimpse of people who chose their family."

Early in the evening on January 29, hundreds of people filed into a small assembly room at the San Francisco Health Department, psyched for the night's adventure: They were volunteers for the city's annual "point in time" homeless count, which was taking place simultaneously in cities across the United States.

Cities are required to participate in the count, which is based on criteria provided by the Department of Housing and Urban Development. The data is used by legislators, government agencies, city officials, nonprofits—anyone who is interested, really—to evaluate strategies intended to curb homelessness. With deadlines approaching for the Obama Administration's goal of ending chronic and veteran homelessness by the end of 2015—this year's results would be particularly important.

The White House sent its chief of staff to rally SF's volunteers: "It is a huge service to the country."

The administration even dispatched officials to rally the troops—San Francisco got White House Chief of Staff Denis McDonough. "Tonight in Orlando, Tucson, Los Angeles—everybody is going out to do exactly the same thing you are," he told the volunteers. "It is a huge service to the country because you are going to give us the data that policymakers, academics, the president, and the first lady are going to use to hold us to account."

McDonough chose San Francisco, he said, in part because it has embraced the president's initiatives and done a good job at reducing its chronic, child, and veteran homeless populations. It would be up to this crowd to find out how much work was still needed.

Jeff rarely smiles. After 10 years sleeping on sidewalks in San Francisco, stealing to survive and score his next heroin fix, an infection robbed him of most of his teeth. "If you have a big nose, well, no one can blame you," he says. "It's just the way you were born. But if you have no teeth, it's proof that you've fucked up real bad—that you must be nothing but a fuckup."

He wasn't always this way, but his life was hard from the beginning. Jeff spent his early years fearing his mother would kill him. She suffered from delusions and was shuffled in and out of mental health facilities. Sometimes she was violent, hurling insults and threatening her family with knives.

Jeff's father, though, was his hero. He was a garbage collector—"the best in the city"—and Jeff followed in his footsteps: "I became a garbage collector too. I worked and paid taxes for 12 years. But one day I was caught with a tiny bit of pot in my urine and was fired on the spot."

It was devastating. Jeff fell into a deep depression. He started using crack, and later heroin. Soon, he had burned through his money, lost his apartment, and was abandoned by his fiancé. "Being a garbage man was everything to me. When I lost that, I lost everything."

A social worker helped Jeff get off drugs and into stable housing: "Maybe I'll live 'til 50."

Jeff's is one of the many stories of homelessness chronicled in Robert Okin's new bookSilent Voices. As a psychiatrist who has served as the Commissioner at the Department of Mental Health in both Massachusetts and Vermont, a professor emeritus at the University of California-San Francisco School of Medicine, and former Chief of Service in the San Francisco General Hospital's Department of Psychiatry, Okin has worked with homeless patients throughout his career.

Still, as he passed them daily on the streets of the city where he lived and worked, he began to wonder about who they really were. How did they cope with their stresses, what did they think about, and how did they make it through the cold, foggy San Francisco nights? "I understood their lives from a clinical point of view. I didn’t really get it from a humanistic point of view," Okin told me. "I wanted to know about the details."

So, he started asking. He would broach conversations on street corners, inquiring about street people's pasts, survival strategies, and inner lives. "Behind the rags and the carts and the strange behaviors—behind the stigma of poverty and mental illness—are human beings with a lot of the same hopes and feelings, joys, frustrations that the rest of us have," he says. "I wanted to help readers see that, when they pass someone on the street who is sleeping, they should try to remember: That person has a story."

Daniel, in the financial district, panhandles by day and sleeps in doorways at night.

Daniel's feet.

In the book, Okin pairs photographic portraits with extended quotes from his subjects, offering context only when needed. He'd rather let his readers experience the stories as he did. Not surprisingly, they are full of hardship, grief, and regret. "Many believed that they were at fault for their own predicaments," Okin says. "Even when you heard the stories that these people had—abused, neglected. Many of them just never had a chance."

Some people wouldn't engage with Okin: "I sat beside him for over an hour. He seemed completely unaware of my presence, so intently was he examining his sock."

Drug addiction is a common theme. People started using for a variety of reasons, especially those who experienced neglect or abuse. Once they landed on the streets, they were caught in a perpetual cycle. Addictions are particularly hard to break when you don't have a roof over your head, Okin says. As one subject puts it, "Living on the street is so bad, you have to be either stoned or crazy to bear it."

In his 20s, David became convinced extraterrestrial creatures were shooting particles into his brain: "The angels of suffering are screeching at me!"

David's room in one of the city's "transient hotels."

Linda says he named himself after his mother, whom he doesn't remember. He was put in foster care at age five and raised in group homes: "When I get too lonely, which is all the time, I listen to music. Can't live without it."

Mental illness was also common, but there was often an associated history of childhood trauma, abandonment, and mistreatment. Many of the mentally ill women he encountered had been sexually abused or exploited as children.

Just hearing the stories took a toll on Okin. "I would come home the end of the day, sometimes feeling connected and exhilarated, but often feeling sad, with a lump in my throat," he says. "It really touched me deeply. There were many times when I just felt I couldn't go out the next day. It was too sad, too demoralizing."

What kept him going, he says, is the thought that sharing the stories might inspire others to take on the issue of homelessness. Given the right programs, he knew that many of his subject could pull themselves out of the abyss. "You need to get people into housing first, and then they are much more likely to get off drugs, get a job, or in other ways pull themselves together. They are able to function much more constructively if they don't have to fight for survival."

Barbara became homeless after her husband OD'd. "My son could see me from the window while I was out in the street. To this day I see his face looking out the window at me, wanting me to come in." She was later diagnosed with cancer, and died before Okin's book was published.

Indeed, "housing first" programs are being implemented across the country. They pair chronically homeless people with subsidized long-term housing and in-house social services. The strategy has proved successful, not just in getting thousands of homeless off the streets, but in helping them rebuild their lives. It sounds expensive, but in fact it's cheaper than band-aid approaches, which are laced with costs for hospital stays and incarceration.

Michael told Okin he speaks to God. "He began talking softly to himself and then more loudly to the bell that clanged in the tower of the Ferry Building."

Utah's highly successful program, the subject of the cover story in our March/April print edition, is close to ending chronic homelessness in that state. "This problem can be solved in San Francisco just like it can be solved in Utah," Okin told me. "The fact that there are now some successes will remove the argument that this is unsolvable. It will give states and the people in charge of budgets the comfort that they need—but ultimately the people in this city must demand the political will from their elected officials." (Also read: "Just How Does a City Count Its Homeless? I Tagged Along To Find Out.")

Jeff is one of the lucky ones. After being homeless for a decade he landed in a drug treatment program, and it may have saved his life. While living on the streets he suffered an infection that left abscesses all over his body: "They wouldn't heal while I was on the street, even with antibiotics. Too much stress, too much exposure to bad weather, too many heroin injections."

But, with the help of the program, he was placed in housing and assigned a social worker, who he says saw him every day for a year. Now he's been clean for more than a year and landed a paid, part-time job with the program that assisted him. He also volunteers at an animal shelter, and has even adopted a kitten. "She's my best friend. I've also started to think about what else I want to do with my life. Maybe I'll live 'til 50."